Application of stapled transanal rectum resection in the treatment of obstructed defecation syndrome

Abstract

To evaluate the effectiveness and safety of stapled transanal rectum resection (STARR) in the treatment of obstructed defecation syndrome (ODS). Fifty-six patients with ODS who had rectocele and/or intussusception were treated with STARR from January 2007 to August 2008. The incidence of preoperative and postoperative symptoms of ODS was compared. Symptomatic relief was also observed by using scoring system. The average operation time was 28 min, and in the first 3 days after operation the average VAS pain score was 3.2 points. Two patients experienced mild anal incontinence when followed-up to 6 months; 2 patients suffered mild anal pain during defecation due to slight anastomotic inflammation 2 and 4 months after the operation, respectively. No other complications was found. The mean follow-up period was 8 months after surgery, and the rate of symptoms of ODS reduced significantly compared with that before surgery, in particular the incidence of the difficult and obstructive defecation feelings decreased for more than 50 percent (P<0.05). Compared with that before the operation, the sense of no emptying stool decreased for 65 percent and all the other symptoms reduced for more than 72 percent (all P<0.05). The stapled transanal rectum resection is simple, less invasive, less painful and with fewer complications and more satisfactory recent effect in treating obstructed defecation syndrome.